Editorial: Polygenic scores in child and adolescent psychiatry – strengths, weaknesses, opportunities and threats

Abstract

Polygenic scores estimate an individual’s genetic liability for a particular disorder or trait. They are based on current knowledge of the trait’s genetic architecture and focus on common genetic variants. In this editorial, I will discuss some of the strengths, weaknesses, opportunities and threats (SWOT) to polygenic scores within the context of child and adolescent psychiatry. I consider how the potential application of polygenic scores in health settings has some parallels with existing practices, but that polygenic scores also undoubtedly raise unique challenges. This SWOT analysis is accompanied by discussion of some new findings using polygenic scores in this issue of Journal of Child Psychology and Psychiatry.

Genetic nurture effects on education: a systematic review and meta-analysis

“…The most recent GWAS for educational attainment (hereafter referred to as “EA GWAS”) identified 1271 lead variants associated with year of schooling completed (Lee et al, 2018). Based on the EA GWAS, a polygenic score (PGS) can be derived to provide a single value reflecting an individual’s genetic propensity to educational attainment (referred to as “EA PGS”; it is a sum of an individual’s effect alleles weighted by effect sizes obtained from the EA GWAS)(Dudbridge, 2013; Ronald, 2020). The top performing EA PGS explained 11-13% of the variance in educational attainment in two replication samples (Lee et al, 2018).…”

5.29 Systematic Review: How the Adhd Polygenic Risk Score Adds to Our Understanding of Adhd and Other Traits

“…The ADHD PRS predicted depressive disorders only using algorithmbased research diagnoses (OR = 1. 19 (1.06-1.33) p =.0027) and not using registry clinical or screening research diagnoses.…”

“…It is possible that a more predictive ADHD PRS will be used in the future, in combination with other known risk factors and clinical features, to support health services with prediction, diagnosis and intervention 131 . As pointed out elsewhere, there are some similarities between existing successful health screening practices --such as the newborn APGAR score and neonatal blood spot screening --with how a PRS would be obtained and could work in practice 19 .…”

“…A PRS is thus a major methodological development, not only for the genetic field, but in terms of potential utility in a range of other research fields due to the fact that they can be easily calculated in any genotyped sample. The potential of PRS for clinical utility, screening and personalized health is currently a major topic of debate 18,19 .…”

Editorial: The Value of Genetically Informative Designs to Understand Pathways of Intergenerational Transmission and Direction of Causality

“…5 Although direct clinical applications of molecular genetic information are not around the corner, embracing the opportunities provided by developments in the field of genetics will pave new ways to improve prevention and intervention strategies for child and adolescent psychiatric problems. Ronald 6 provides an excellent SWAT analysis of polygenic scores for child and adolescent psychiatry and provides an overview of how PRS add to our understanding. 7 A balanced overview of the opportunities and challenges of PRS in psychiatry can also be enjoyed while taking a walk via this excellent podcast starring Professor Cathryn Lewis (https:// www.acamh.org/blog/investigating-the-interplay-of-geneticsand-environment-on-development-prof-cathryn-lewis/).…”